The goal of this project is to translate motivational alcohol drinking interventions successful in the primary care setting to the Emergency Department (ED) environment by implementing screening, brief intervention, and referral to treatment (SBIRT) services by ED clinicians to reduce at-risk drinking among ED patients. The specific objectives of this proposal is to fund the University of California, San Diego (UCSD) medical center's ED participation as a local site for (1) the National Alcohol Screening Day (NASD) ED alcohol education project (R-25); and (2) the NASD ED multi-center study testing the effectiveness of SBIRT as practiced by ED clinical staff as a part of regular care (R-25 and R-21). This local site proposal will be coordinated and linked with the R-25 and R-21 proposals developed as a part of the NASD Academic ED Collaboration. As a local site, UCSD ED clinicians will participate in staff education on SBIRT including a local educational workshop, internet web-based training, video conferencing, and other activities associated with NASD; as well as conduct provider surveys assessing adoption of SBIRT in conjunction with the R-25 project. As a part of the multi-center trial, the UCSD ED will screen 500 patients for alcohol at-risk or dependent drinking during two 2-week time periods: a control period conducted prior to NASD; and an intervention period conducted during NASD. Patients who screen for at-risk or dependent drinking will be enrolled in the study after informed consent. Control period patients will receive a written referral to alcohol services; intervention period patients will receive the written referral as well as a brief face-to-face intervention by clinical staff based on the NASD training. Follow-up patient surveys will be conducted at 3 and 6 months after the ED visit using an interactive voice response (IVR) system developed by the R-21 site to contact enrolled patients. UCSD ED investigators will be responsible for following up on difficult to reach) patients. Local data and survey results will be submitted to the R-25 and R-21 sites for analysis.